IQC Frequency Determination Form template
A form in the Internal Quality Control procedure (PR23), mapped to ISO 15189:2022 clause 7.3.7.2. Fill it in whenever the task occurs. Used by the laboratory team.
FormISO 15189 · 7.3.7.2As needed
Calculated automaticallyRed = outside limits
Your LaboratoryIQC Frequency Determination Form | YL-LAB-FRM-23-F01 v1.0
Record: IQC Frequency Determination Form — October 2026
Frequency of IQC must consider stability of reagents, robustness of instrument, and risk of harm to patients.
| No. | Test / Analyte | Section | Control Level(s) (L1/L2/L3) | QC Material (Name / Lot No.) | Frequency (Per Analyser Run/Daily/Weekly) | Minimum No. per Run | Risk Level (H/M/L) | Justification | Approved by | Effective Date | Review Date |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Glucose | Haematology | QC level 1 · lot 2409-A | R. Naidoo | Chemistry analyser | REF-26-001 | S. Dlamini | 2026-10-01 | 2026-10-01 | ||
| 2 | Creatinine | Chemistry | QC level 1 · lot 2409-B | S. Dlamini | Centrifuge 2 | REF-26-002 | A. Mensah | 2026-10-08 | 2026-10-08 | ||
| 3 | ALT | Microbiology | QC level 1 · lot 2409-C | A. Mensah | Haematology analyser | REF-26-003 | L. Banda | 2026-10-15 | 2026-10-15 | ||
| 4 | Haemoglobin | Reception | QC level 1 · lot 2409-A | L. Banda | Water bath | REF-26-004 | K. Otieno | 2026-10-22 | 2026-10-22 | ||
| 5 | Potassium | Haematology | QC level 1 · lot 2409-B | K. Otieno | Chemistry analyser | REF-26-005 | T. Moyo | 2026-10-29 | 2026-10-29 | ||
| 6 | Glucose | Chemistry | QC level 1 · lot 2409-C | T. Moyo | Centrifuge 2 | REF-26-006 | R. Naidoo | 2026-11-05 | 2026-11-05 | ||
| 7 | Creatinine | Microbiology | QC level 1 · lot 2409-A | R. Naidoo | Haematology analyser | REF-26-007 | S. Dlamini | 2026-11-12 | 2026-11-12 | ||
| 8 | ALT | Reception | QC level 1 · lot 2409-B | S. Dlamini | Water bath | REF-26-008 | A. Mensah | 2026-11-19 | 2026-11-19 |
Sign-off
| Role | Name | Signature | Date |
|---|---|---|---|
| Completed by | |||
| Reviewed by |
Shaded cells are calculated automatically. Values in red are outside their limits. † marks a corrected value (see Corrections).
Controlled document. Printed copies are uncontrolled unless stamped.Page 1
A4 landscape · first page · showing 8 of 8 rowsExactly as LabToolkit Pro prints it — with your logo and colours
What it records
- Test / Analyte
- Section
- Control Level(s) (L1/L2/L3)
- QC Material (Name / Lot No.)
- Frequency (Per Analyser Run/Daily/Weekly)
- Minimum No. per Run
- Risk Level (H/M/L)
- Justification
- Approved by
- Effective Date
- Review Date
Instructions on the form
- Frequency of IQC must consider stability of reagents, robustness of instrument, and risk of harm to patients.
Sign-off
- Completed by
- Reviewed by
Related templates
- In-house IQC Preparation Log (PR23-F02)
- IQC Statistical Tool — Levey-jennings Chart Setup (PR23-F03)
- IQC Daily Log (PR23-F04)
- CV Calculator — Alternative IQC Method (PR23-F05)
- Levey-Jennings chart & Westgard multirule monitor (PR23-T01)
- Sigma metric & QC strategy planner (PR23-T02)
- Guide: Levey-Jennings charts and Westgard rules
- Guide: ISO 15189 documentation checklist
Clause references are to ISO 15189:2022; check them against your licensed copy of the standard.